Provider Demographics
NPI:1114387792
Name:MCMURRAY, KIMBERLEE TAYLOR (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:TAYLOR
Last Name:MCMURRAY
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 FERNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-5215
Mailing Address - Country:US
Mailing Address - Phone:318-771-1519
Mailing Address - Fax:
Practice Address - Street 1:3003 KNIGHT ST STE 115
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2561
Practice Address - Country:US
Practice Address - Phone:318-227-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5776101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor